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Biomedical subjects

R C Verschueren

Publications and source records attributed to R C Verschueren.

At least 37 records · Page 2Linked to original sources
PubMed1988

Juvenile polyps at the site of a ureterosigmoidostomy. Report of five cases.

Five cases of juvenile polyps at the level of a ureterosigmoidostomy are described. One of the juvenile polyps contained an area of adenomatous tissue. The mechanisms that might cause these polyps are discussed. The mechanisms that might cause these polyps are discussed. The presence of adenomatous tissue in one of the patients may be a step of the polyp cancer sequence at the level of ureteral implantation in the colon. The authors make a plea for a call-up and close follow-up of all patients who have a ureterosigmoidostomy.

Adult↗
PubMed1987

Staging laparotomy for inoperable or borderline operable cancer of the rectum.

The authors report their experience with the staging laparotomy as a means of identifying and preparing patients for high-dose preoperative radiotherapy. Twelve patients had clinically unresectable cancers of the rectum. The goal of the staging laparotomy is to assess mobility and tumor size by means of bimanual palpation, to stage the abdominal cavity, and to fashion an end colostomy at the level of the descending colon. Eight patients ultimately underwent radical resection. Three died during follow-up due to hematogenic metastases without recurrent pelvic disease. Five patients are alive with no evidence of disease and have been followed for an average of 34 months (range, 20 to 64 months).

Adult↗
PubMed1987

Long-term survival after vinblastine, bleomycin, and cisplatin treatment in patients with germ cell tumors of the ovary: an update.

Thirteen patients with a malignant germ cell tumor of the ovary have been treated with a combination of vinblastine, bleomycin, and cisplatin (VBP). In 12 patients a complete remission was reached, which was maintained in 10 of these patients. One patient with large tumor residues and a partial remission became CR after surgery. The tumor recurred in 2 patients after 6 and 27 months. Overall, 11 of these patients are in long-term remission, from 14 to 84 months after the start of treatment. VBP is an effective treatment for malignant germ cell tumors of the ovary, even in patients with large tumor residuals.

Adolescent↗
PubMed1986

[Management of the presacral space following colorectal surgery of malignant tumors. Results of 50 consecutive operations].

Septic complications often arise in the presacral space after low anterior resections, abdominoperineal resections and extended Hartmann procedures for a malignant process. In the framework of a prospective study the authors investigated the impact of leaving the pelvic peritoneum open and the use of a presacral irrigation suction system during 24 hours. This article reports about the experience with 50 consecutive patients. Wound infections occurred in 2 patients (4%). The average postoperative hospital stay was 15 days. It appears from this study that the use of an irrigation suction system in the presacral space contributes to avoid septic complications and shortens the hospital stay.

Aged↗
PubMed1985

Viability of tumor cells in the irrigation fluid of the Cavitron Ultrasonic Surgical Aspirator (CUSA) after tumor fragmentation.

The Cavitron Ultrasonic Surgical Aspirator (CUSA) (Cooper Medical, Stamford, CT) is a relatively new surgical modality. The risk of tumor seeding during tumor surgery has not been studied until now. Hanks balanced salt solution, normal saline, distilled water, and Dakin's solution were used as irrigation fluids during CUSA fragmentation of Lewis lung carcinoma in C57B1/10 female mice, using the machine at 40% of its maximal output. All four irrigation fluids contained viable tumor cells--growing in vitro as well as in vivo--after tumor aspiration. Normal saline was also used when the machine was operating at its maximal output. Under these conditions, the irrigation fluid contained viable tumor cells as well.

Animals↗
PubMed1985

Palliative and curative electrocoagulation for rectal cancer. Experience and results.

The 18-year experience with electrocoagulation of rectal cancer in 51 patients is reported. The "boiling" technique used in this study is described. Electrocoagulation for palliative purpose was carried out in 18 patients. One patient is alive without evidence of disease after 4 years. The remaining 17 patients died within 2 years. Electrocoagulation for cure was performed in 33 patients. In two patients abdominoperineal resection was needed for residual tumor. All cases were strictly followed, and none of the patients died of cancer. Recurrent tumor was never seen, and the crude 5-year survival was 71%. The authors describe the criteria for selection any patient should meet in order to be eligible for electrocoagulation with curative purpose and advocate caution in making the choice between radical and local surgery.

Adult↗
PubMed1984

Surgical aspects of radiation enteritis of the small bowel.

Injury to the small bowel is one of the tragic complications of radiotherapy. We performed a retrospective analysis of patients operated upon for stenosis, perforation, fistulization, and chronic blood loss of the small bowel after radiotherapy for multiple malignant diseases. In the period 1970 to 1982 in the Department of General Surgery of the St. Radboud University Hospital, Nijmegen, and the Department of Surgical Oncology of the State University, Groningen, 27 patients were treated surgically. Twenty patients presented with obstruction. In 17 patients a side-to-side ileotransversostomy was performed; in three the injured bowel was resected. Of the five patients with fistulization, three underwent a bypass procedure; in two cases the affected bowel was resected. In one patient with perforation, a resection was performed, as in a patient with chronic blood loss. Two of the 20 patients (10 per cent) in whom the diseased bowel was bypassed died postoperatively. Of the seven patients whose affected bowel was resected four (57 per cent) died of intra-abdominal sepsis. Management of the patient with chronic radiation enteritis is discussed. We conclude, on the basis of our experience, that in patients with obstruction and fistulization, a bypass procedure of the affected bowel is a safe method of treatment. In case of resection, the anastomosis should be performed during a second operation.

Adult↗
PubMed1984

The rubber dam as a means to isolate contaminated peritoneal defects after colonic resection.

After colonic resections, peritoneal defects exposed to colonic flora and blood may become the seat of localized peritonitis and cause small-bowel adhesions and obstruction. In the past five years, we have seen 14 patients where one or both of these complications was anticipated for one of the following reasons: presence of an abscess cavity, local infection or accidental tear of the colon. In these patients a rubber sheet was stitched to the edges of the peritoneal defect with absorbable sutures and brought out through the abdominal wall. In all patients the rubber dam functioned as a passive drain and as a barrier between the peritoneal defect and the small bowel. Three weeks later the rubber dam was removed by traction. None of these patients developed small-bowel obstruction and no adverse effects from the rubber sheet were seen. The working mechanism of the rubber dam was investigated in female Wistar rats. After removing the peritoneum between the left kidney and pelvis, the defect was covered with a rubber dam. A capsule with a standard solution of Escherichia coli, Bacteroides fragilis, and autoclaved feces was used to initiate peritonitis under the rubber dam. The rubber proved to act as an efficient drain and barrier. No abscesses or small-bowel adhesions were seen. In the control group, 75 per cent of the animals died from generalized peritonitis or developed an abscess.

Animals↗
PubMed1982

The viability of cells in the waste products of CO2-laser evaporation of Cloudman mouse melanomas.

The viability of cells present in waste products originating during CO2-laser evaporation of Cloudman S91 mouse melanomas was investigated. Cytologic smears showed mainly carbonized particles and thermally damaged cells but some morphologically intact cells as well. Viability was tested with the trypan blue test, by in vitro culture and intramuscular and intraperitoneal inoculations in syngeneic mice. No dye-excluding cells were found in the trypan blue test. Growth was noted neither in vitro nor in vivo in the 127 mice, intramuscularly or intraperitoneally injected with 10(5) x 10(5)/10 microliter smoke or debris particles, and killed four weeks after inoculation. Viable tumor cells, derived from a Cloudman melanoma cell line and added to the smoke and debris suspensions, remained viable. Thus, a toxic influence of smoke and debris particles in viable tumor cells, which would make the viability tests meaningless, was excluded. It is highly unlikely that viable tumor cells do occur in the waste products of CO2-laser tumor vaporization.

Animals↗
PubMed1979

The curative treatment of rectal cancer at the Cleveland Clinic.

This article reviews the policy of the Cleveland Clinic regarding the curative treatment of rectal cancer. The use of Turnbull's no-touch technic permits avoidance of peroperative tumor seeding via the lumen of the bowel or the lymphovascular pedicle. The postoperative accumulation of blood in the presacral space is precluded by leaving the peritoneum of the pelvis open and by irrigation and suction via sump drains. The authors review the different factors influencing the choice of treatment.

Humans↗
PubMed1975

Experimental surgery on the Cloudman S91 melanoma with the carbon-dioxide laser.

The continuous wave CO2 laser lacks a number of draw-backs of the pulsed Ruby laser, and seems attractive for tumor surgery. We compared the CO2 laser with conventional surgery in experiments on mice bearing the Cloudman S91 melanoma. We had the same rate of local recurrence and lung metastasis in both techniques.

Animals↗
PubMed1975

The carbon dioxide laser; some possibilities in surgery.

The CO2 laser emits an infra red beam with a wavelength of 10,6 mu. Focussing this beam gives a tremendous energy density. The strong absorption of this wavelength allows tissue evaporation at the focal point of the beam. The first surgical application is the use of this laser as a light knife. Satisfying haemostasis can be obtained. Vessels with an internal diameter up to 0,5 mm being sealed, haemostatic cutting is possible. Even cortical bone can easily be cut with this instrument. The ability to vaporize tissues can be used for tumor destruction. Special attachments for endoscopic surgery are available. Experimental work in the rectum and on vocal cords has been done in our laboratory. The important problem in laser surgery is the necrosis on the edges. Investigations about the viability of the margins, showed that the width of the necrosis is in linear relationship with the rate of the exposure time. For an exposure of 1/10th of a second this width was about 130 mu, for an exposure of 6 seconds about 600 mu. After one year of experimental work with the CO2 laser we are convinced that this instrument might prove to be a reliable tool in surgery.

Animals↗
PubMedDate not supplied

Selective use of preoperative radiotherapy in the treatment of cancer in the lower two thirds of the rectum.

PURPOSE: The authors review the result of the selection of patients with a low rectal cancer for pre-operative radiotherapy. METHODS: The selection was based on the findings of digital examination eventually combined with surgical staging consisting of bimanual palpation during a staging laparotomy or "trial" operation. This selection was used to divide the patients into three groups: one where local radicality could be expected from primary surgery (group 1), one with deeply infiltrating, but mobile tumours requiring 10 x 3 Gy pre-operative radiotherapy (group 2) and one with fixed or borderline resectable tumours requiring protracted pre-operative radiotherapy with 55-59 Gy (group 3). One hundred and one patients were eligible for this study. A resection aiming for pelvic radicality was carried out in 94 patients: primary resection in 38 (group 1), surgery subsequent to 10 x 3 Gy pre-operative radiotherapy in 20 (group 2) and 55-59 Gy in 36 (group 3). RESULTS: The calculated risk of local recurrence at 5 years was 15% (95% C.I. 4-27) for group 1, 8% (95% C.I. 0-20) for group 2 and 30% (95% C.I. 16-44) for group 3. The calculated 5 years survival for the 3 groups was respectively 60%, 49% and 39%. CONCLUSION: The overlap in local recurrence rate between the three groups suggests a substantial downgrading by this approach of selective use of pre-operative radiotherapy in the patients with the most advanced tumour. Notwithstanding recent improvements of imaging techniques there still is a place for the staging laparotomy in the selection of the treatment strategy for advanced rectal cancers.

Adult↗